Pharmacological Treatment of Neuropathic Pain€¢Pharmacological treatment of neuropathic pain...
Transcript of Pharmacological Treatment of Neuropathic Pain€¢Pharmacological treatment of neuropathic pain...
Introduction
• A diagnosis of neuropathic pain
• Pharmacological treatment of neuropathic
pain
• Neuropathic pain in cancer patients
A diagnosis of neuropathic pain-Hypothesis I
One should NOT treat neuropathic pain,
that is NOT neuropathic pain
A diagnosis of neuropathic pain
-Ataxia
-Loss of Touch
-Loss of Dexterity
Large
diamete
r
Small diameter
-Muscle Atrophy
-Loss of
Strength
Large
diameter
sensory nerve
fibers
-Autonomic dysfunction
-Loss of thermo-perception
-Neuropathic Pain
Motor nerve
fibers
Small diameter
sensory nerve
fibers
Pharmacological treatment of neuropathic pain-Hypothesis II
One should NOT treat mild neuropathic
pain
Pharmacological treatment of neuropathic pain
Lancet Neurol. 2015; 14: 162-173
Pain Practice 2014; 14(3): 183-295
Pharmacological treatment of neuropathic pain
Pain Practice 2014; 14(3): 183-
295
Pain 2014; 155: 2263-
2273
Pharmacological treatment of neuropathic pain-Hypothesis III
Pharmacological treatment of
neuropathic pain should be based on
clinical evidence and rational
pharmacotherapy
Pharmacological treatment of neuropathic pain
Groeneveld & Jongen. Tijdschr. Neurol. Neurochir. 2013; 114:
119-129
Pharmacological treatment of neuropathic pain
Groeneveld & Jongen. Tijdschr. Neurol. Neurochir. 2013; 114:
119-129
Neuropathic pain in cancer patients-Hypothesis IV
Neuropathic pain in cancer patients is a
special entity, that encompasses both
mixed and purely neuropathic pain
Neuropathic pain in cancer patients
• Nociceptive pain (due to cancer)
• Mixed nociceptive-neuropathic pain (due to
cancer)
• Purely neuropathic cancer pain (due to
cancer treatment)
Pharmacological treatment of neuropathic pain in cancer patients
J Pain Symptom Manage. 2013; 46: 581-590
Conclusions
• One should not treat neuropathic pain, that is
not neuropathic pain
• One should not treat mild neuropathic pain
• Pharmacological treatment of neuropathic
pain should be based on clinical evidence
and rational pharmacotherapy
• Neuropathic pain in cancer patients is a
special entity, that encompasses both mixed
and purely neuropathic pain